Could nipples still be puffy post-op from having too much gland/fat removed or..

[tonysoprano]

or from the way the scar was sewn closed, or from adhesion scars ?

I have had 2 surgeries now -both 5 years ago, and since the 6-week mark post-surgery have once again had puffy nipples , but now almost with a "deflated-tire" look to them, but two puffy conical-like domes sitting atop the chest, as opposed to flush with my chest.

There does not feel like there is anyything directly beneath my nips - neither fat nor gland - but when I let them relax they puff out, in a very pointy,puffy shape.

They were ideal for the first 6 weeks post-op (in 2005), but ever since then have been extremely puffy and protrusive (almost worse than pre-op state) with scars on them to boot.

The surgeon who did both my surgeries has claimed that there is just no more fat or gland to be removed here, and that nothing further can be done in this case - YET THESE NIPPLES ARE STILL THESE PUFFY,DEFLATED-LOOKING CONES SITTING on top of the chest like small beacons...

Has anyone else here - whether a surgeon or a patient - heard of puffy nipples still being present once all fat/gland has been removed (and maybe too much perhaps)??

Could it be the way the nipples were sewn closed or adhesion scars or is there another explanation?

Someone please help, as I would really love to go for a Third and final surgery (obviously not with the same surgeon now - spite me twice - shame on me") if these nipples are fixable, and if the whole situation here is indeed still salvagable.....

sorry - currently have no pics.. but could take some next week when I get hold of a camera, I suppose...

cheers guys,

Tony

[Ronaldinho123]

I am 22 years old and I work out and play soccer, so my body is trimmed. I had puffy nipples too, and 4 months ago I got the surgery done. But my nipples are still puffy. Under my right nipple there is something hard, I dont know what it is, probably fat or remaining gland.  But under my left nipple it feels "empty" like you explain it, and it is still very puffy and pointy. And it bugs me alot, and I am going to see another surgeon in a month and get another surgery in 2 months. Because it sucks to have pointy and puffy nipples.

I dont know why it is like that, but I am going to ask my other surgeon when I see him in a month. Either it has been sewed back on in a wrong way, or maybe the nipple size has been extracted by having the gland under it for such a long time. If you know what I mean.
Maybe if the nipple size is too big to be flat and a areola reduction surgery is needed. I dont know. But I am going to ask my surgeon in a month.

[DrBermant]

or from the way the scar was sewn closed, or from adhesion scars ?

I have had 2 surgeries now -both 5 years ago, and since the 6-week mark post-surgery have once again had puffy nipples , but now almost with a "deflated-tire" look to them, but two puffy conical-like domes sitting atop the chest, as opposed to flush with my chest.

There does not feel like there is anyything directly beneath my nips - neither fat nor gland - but when I let them relax they puff out, in a very pointy,puffy shape.

They were ideal for the first 6 weeks post-op (in 2005), but ever since then have been extremely puffy and protrusive (almost worse than pre-op state) with scars on them to boot.

The surgeon who did both my surgeries has claimed that there is just no more fat or gland to be removed here, and that nothing further can be done in this case - YET THESE NIPPLES ARE STILL THESE PUFFY,DEFLATED-LOOKING CONES SITTING on top of the chest like small beacons...

Has anyone else here - whether a surgeon or a patient - heard of puffy nipples still being present once all fat/gland has been removed (and maybe too much perhaps)??

Could it be the way the nipples were sewn closed or adhesion scars or is there another explanation?

Someone please help, as I would really love to go for a Third and final surgery (obviously not with the same surgeon now - spite me twice - shame on me") if these nipples are fixable, and if the whole situation here is indeed still salvagable.....

sorry - currently have no pics.. but could take some next week when I get hold of a camera, I suppose...

cheers guys,

Tony

The most common cause of Puffy Nipple Gynecomastia Complication After Surgery is residual gland scar tissue, and fat. Much more rare is redundant skin. Another cause is the male nipple that instead of Flattening Nipples on Stimulation of Areola Muscle, the nipple protrudes more. Surgery will not address the last issue of stimulation deformity. The others have revision surgery options in the hands of an experienced Revision Gynecomastia Surgeon. The best way to explore such options is during a consultation or evaluation. Why not post some of my Standard After Gynecomastia Surgery pictures to better help others understand your concerns.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[kbob]

There were few other member on this site that have the same condition (areolas/nipples protruding when contracted yet it feels empty underneath). I have the same condition. I am surprised that no doctor has commented on this or has experienced this in their practice. I believe the protruding areolas/nipples happen when these circumstances exist:

1) The individual has a well developed and sensitive areolar muscle (small muscle fibers part of the areola complex) that cause areola contraction.
2) Too much fat is removed from underneath the areola and the areola does not attach firmly to the tissues underneath, but instead "floats" over the depression.

When the areolar muscle fibers contract there is nothing providing "structural support" to the areola, nothing slightly holding it down. When the muscle contracts the areola circumference shrinks and areola skin pops out.
Uneven soft scaring can develop under the areola, further contributing to the distortion.

I believe the potential "fix" to this condition is to remove any scar tissue from under the areola and reposition fat under the areola so that it can uniformly attach to it.

Any thoughts on this from the supporting doctors?

  Regards,
       Kevin

[majorsituation]

Hi Kevin,

I agree with you wen u say surgeons dont answer to the point. Especially, Dr. Bermant who simply cuts and copies the same answers everywhere. Those answers can be very general am sure that each person has got his own way of healing. I feel a better way of helping would be to answer the queries to the point. No offense to Dr. Bermant, but his replies are just not answer for individualistic questions.

Tony Soprano,
Dude be realistic about your expectations... The reason we go in for correction surgeries is we dont have it naturally. So be happy with whatever results you get. They r some with flat nipples & they are some with puffy... cant help it mate!!! i had a surgery 6 weeks bak.. nopples still bit puffy but its fine... i look much better , t's fit me better & trust me no one notices puffy nips thru clothes... the result is more psychological... your not use to your new chest, & u dont know how a good chest looks like... therefore you get conscious & feel tat it still seems bad to ppl... so chill dude!!! and have fun....   

[DrBermant]

Hi Kevin,

I agree with you wen u say surgeons dont answer to the point. Especially, Dr. Bermant who simply cuts and copies the same answers everywhere. Those answers can be very general am sure that each person has got his own way of healing. I feel a better way of helping would be to answer the queries to the point. No offense to Dr. Bermant, but his replies are just not answer for individualistic questions.
  

After over 3177 answers and many years of posting here, there are very few questions about gynecomastia that I have not already answered on this forum. The search tool on this forum is powerful. New answers to the same exact questions make little sense unless I have built new resources to better explain the issues. Those resources continue to evolve since I build my own web pages to address issues of importance. These links provide real examples, further details, drawings, and videos on the points in question. I normally modify the new answer to the details of the question(s) posed. Use the site search tools and pick oldest topics first and then use most recent topics first and you can see the evolution of any answer on this forum. Such searches can prove interesting watching consistency, and changes in thinking on a topic. Check this post for an example:

http://www.gynecomastia.org/smf/index.php?topic=21010.msg142812#msg142812

I answer in generalities since specific advice can establish a doctor patient relationship that the posting doctor can be held accountable for. Such answers without appropriate additional details can be inaccurate and irresponsible. Answering in a general fashion can still provide a great deal of information. For my patients, I then make specific recommendations and help them explore their problems in exquisite details during a consultation.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[kbob]

Sorry majorsituation but you have steered the discussion into a political discussion. That certainly was not my intent with my post. Let's stay with the actual issue that the original poster stated.
I would like to hear any doctor's opinion on this condition and my "theory" about it.
Thank you,
    Kevin

[kbob]

One more addition to my post:
The other factor in the areolar deformity could be improper suturing of the areolar muscle layer resulting in the areola deformity when the muscle contracts.
See article at: http://www.springerlink.com/content/363m2t94297m15w0/fulltext.pdf
The article is about female mastoplasty, but it is addressing an issue that applies to any gynecomastia surgery.
I am surprised that this issue seems to be not well known and not commonly considered by cosmetic surgeon. I think some surgeons address this unknowingly by sub-dermal sutures, but many don't.

Any comments?

   Kevin

[hollisterco]

I would really appreciate an answer too. I had the surgery twice. First one in may and the second one, 4 months later, in september. Both times, only my gland was removed. The only thing i don't understand is why the puffiness is still there ? I'm only 2 months post-op right now, but my left nipple looks EXACTLY the same as pre-pre-op but i've seen the amount of gland that the surgeon removed and i'm pretty sure there's nothing more to remove in those nipples. But guess what? i still have puffy nipples..
It would be really nice to have an answer on what could still cause the puffiness at this point..

thank you!

[tonysoprano]

There were few other member on this site that have the same condition (areolas/nipples protruding when contracted yet it feels empty underneath). I have the same condition. I am surprised that no doctor has commented on this or has experienced this in their practice. I believe the protruding areolas/nipples happen when these circumstances exist:

1) The individual has a well developed and sensitive areolar muscle (small muscle fibers part of the areola complex) that cause areola contraction.
2) Too much fat is removed from underneath the areola and the areola does not attach firmly to the tissues underneath, but instead "floats" over the depression.

When the areolar muscle fibers contract there is nothing providing "structural support" to the areola, nothing slightly holding it down. When the muscle contracts the areola circumference shrinks and areola skin pops out.
Uneven soft scaring can develop under the areola, further contributing to the distortion.

I believe the potential "fix" to this condition is to remove any scar tissue from under the areola and reposition fat under the areola so that it can uniformly attach to it.

Any thoughts on this from the supporting doctors?

  Regards,
       Kevin

Kevin,

I am no surgeon by any means, but having had a failed surgery myself, and having spent many years on these boards reading countless posts on all things gyne - puffy nips and post-op-puffy nips in particular - I think you are definitely onto something here.

This seems by far the most physiologically plausible explanation for post-op puffies, and I am pretty sure mine have resulted from a combination of : too much fat being lipo'd directly beneath the nips, nothing being left underneath them any longer (neither very much  fat nor much gland, if any gland remaining) with nothing to fill that void, nothing for the nip to attach itself to, possibly poor re-suturing of the incisions resulting in bad adherence..... and then..... some or ALL of these factors COMPOUNDED by scar tissue formation and the extra distortion that that brings.

Just one thing mate... iN CONTRAST to what you are alluding to re: pectoral muscles contracting ,My nipples look WAY better when my chest muscles are contracted, and REALLY BAD - SUPER PUFFY AND POINTY when RELAXED.

And all the flexing I am doing all the time to make my contour seems relatively normal for just a few seconds, now seems to be building even more muscle in my chest....lol

But yes, everything else you have suggested in this thread, I am inclined to agree with, even on a theoretic basis, and believe many surgeons on these boards would be inclined to support  a lot - maybe even most or all - of what you are suggesting is to blame for many people's post-op-puffies

Kudos to smart thinking and good research!

Tony

[Dr. John Crisler]

I wonder if post-surgery nipple "puffiness"--which did not occur previously, results from cutting the ducts and Cooper's ligaments underlying same.

[Jim119]

Does anyone have any updates on their situation?  I had surgery around 7 months ago and now have the same problem.

I am desperate for answers if anyone can offer a possible fix.

Thanks,

Jim